한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

한의진단명과 진단요건의 표준화 연구 II (표준화 실례) : 2차년도 연구결과 중간 보고

양기상,최선미,최승훈,안규석,박경모,박종현,김성우,신승호,정우열,전병훈,고현,김정범,신상우,김성훈,김동희,권영규,엄현섭,장혜옥 한국한의학연구원 1996 한국한의학연구원논문집 Vol.2 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the second year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows; - differential diagnosis according to condition of body fluid, differentiation of syndromes according to the state of qi and blood, differential diagnosis according to relative excessiveness or deficiency of yin and yang(氣血陰陽津液辨證) - differentiation of diseases according to pathological changes of the viscera and their interrelation - analyzing and differentiating of febrile diseases in accordance with the theory of the six channels(傷寒辨證) The individual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name(異名), notion of diagnosis pattern, index of differentiation of symptoms and signs(辨證指標), the main point of diagnosis, analysis of diagnosis pattern(證候分析), discrimination of diagnosis pattern(證候鑑別), a way of curing a diseases(治法), prescription(處方), herb in common use(常用藥物), diseases appearing the diagnosis pattern(常見疾病), documents(文獻調査). This study was carried out on the basis of the Chinese documents and references.

곰소만에 있어 바지락포자충, Perkinsus sp.의 출현에 관하여

박경일,최광식,최진우,PARK Kyung-Il,CHOI Kwang-Sik,CHOI Jin-Woo 한국수산과학회 1999 한국수산과학회지 Vol.32 No.3

이 연구를 통하여 바지락 대량 폐사가 발생한 전라북도 곰소만에 서식하고 있는 패류, 바지락, R. philipinarium, 굴 C. gigas, 피조개, S. broughtonii, 피뿔고둥, R. venosa, 등을 대상으로 바지락포자충, Perkinsus sp. 감염 여부 및 정량적인 분석을 수행하였다. 바지락포자충의 감염 진단은 Ray(1952)의 방법에 따라 혐기성배양액인 FTM(Fluid Thioglycollate Media)을 이용하여 배양하였으며, Rugol's iodine으로 염색한 후 해부현미경 하에서 검사하였다. 바지락포자충의 감염 정도는 Mackin (1961)의 기준을 따랐으며 일부 시료는 Choi et al. (1989)의 정량적인 방법에 따라 NaOH로 처리한 후 혈구 계수기로 계수하였다. FTM 분석 결과 곰소만에서 채집된 모든 바지락 개체들은 바지락포자충에 감염된 것으로 나타나 감염율 (prevalence)은 $100\%$였다. Mackin의 기준에 따른 감염 정도 판정에서 평균 2.87로 나타나 중간 정도의 감염 정도를 나타냈다. 바지락 육중량 1g 당 바지락포자충의 개체수는 평균 709,028 개체였으며, 바지락 1개체당 최고 4,091,667 개체의 바지락포자충이 발견되었다. 곰소만에서 채집된 패류를 대상으로한 FTM 검사 결과, 굴에서는 바지락 포자충이 전혀 발견되지 않았으며, 새로막과 피뿔고둥에 대한 조사에서는 피조개 2 개체에서만 각 각 6, 10 개의 바지락 포자충이 발견되었고 피뿔고둥에서는 전혀 발견되지 않았다. 조직병리학적 관찰결과 바지락 아가미의 연결조직에서 무정형의 결절에 쌓여있는 직경 $6\~10\;\mu$m의 tropozoites를 발견하였다. 바지락의 비만도는 개체의 각장이 클수록 낮게 나타나는 경향을 보였으며, 바지락 포자충의 감염정도는 각장이 클수록 높게 나타났다. 바지락포자충은 개체에서 개체로 감염되는 관계로 바지락밀도가 높은 지역에서는 그 전염 속도가 높은 것으로 알려져 대량폐사의 원인 중 하나는 밀식으로 판단되었다. Mass mortality of the Manila clam, Ruditapes philippinarum has been reported all along the west and south coast of Korea for the past several years. As a pathogenic agent, Perkinsus sp., an endoparasitic protozoan has been identified in this study and believed to be responsible for the mass mortalities. Prevalence and infection intensity of Perkinsus sp. was investigated from a Manila clam population inhabiting at Komsoe Bay in the west coast where mass mortality of the clam has been reported. A total of 142 Manila clam, 50 oyster, Crassostrea gigas, 10 ark shell, Scapharca broughtonii, and 5 predatory gastropada, Rapana venosa were examined for the presence and the quantity of Perkinsus sp. Ray's fluid thioglycollate medium method (FTM method) with modified Mackin's infection intensity scale and Choi's quantitative method were used in detecting and quantifying the parasite. All individuals of R. philippinarum examined in this study were infected with Perkinsus sp., indicating $100\%$ prevalence while none of the oysters and the gastropods exhibited the parasite. Six to ten individual hypnospores of Perkinsus sp. were counted from the ark shells. The number of hypnospores in the clam tissues varied from 16,667 to 4,091,667, with a mean number of 1,077,628. Average infection intensity according to Mackin's was 2.87, indicating a moderate infection. A negative correlation was observed between the number of Perkinsus sp. in the tissue and the condition index, a ratio tissue wet weight to shell cavity volume. The clam size and the infection intensity in terms of total number of parasites were positively correlated; the bigger clam, the heavier infection. Such high number of Perkinsus sp. counted in the clams could be enough to cause physiological disturbance of clams, such as retarded growth and reproduction. It is also believed that such a high infection leads mortality of the clam via continuous draining of the energy by metabolic activities and reproduction of the parasites. Correlation between the condition index and the infection intensity observed in this study supports this hypothesis.

전국 10개 종합병원 중환자실 환자의 직장내 Vancomycin-resistant Enterococci(VRE) 보균율, 보균의 위험요인 및 유전적 다양성 조사

정희진,송준영,엄중식,김우주,최선주,최정현,이혁,정문현,이광미,신동현,손보라,최종성,우흥정,권정아,이경원,최강원,박승철 대한감염학회 2002 감염 Vol.34 No.5

열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

韓國産 다람쥐의 結核菌 崔少 感染量에 關한 硏究

崔大卿,柳駿,金周德,金聖光,邊于燮 연세대학교 의과대학 1972 연세의대논문집 Vol.5 No.1

운동분류에 따른 체구성 성분 및 BMI의 비교

최명화,권영우,김진해,민경선,민진아 한국스포츠리서치 2001 한국 스포츠 리서치 Vol.12 No.4

The purpose of the present was to investigate the body composition and BMI in different sports groups with classification of sports. 121 male collegiate athletes were recruited from varsity team of golf(n=10), field hokey(n=18), tennis(n=8), judo(n=17), weight lifting(n=27), boxing(n=19) and bicycle(n=22). Sports event can be classified as low static/low dynamic such as golf(LSLD), low static/high dynamic such as hokey and tennis(LSHD), high static/low dynamic such as judo and weight lifting(HSLD), high static/high dynamic(HSHD) such as boxing and bicycle. With classification of sports events, percentage of body fat was significantly higher with HSLD group compared to HSHD group, but no measurable difference was LSLD and LSHD groups. LBM was significantly greater with HSLD group compared to LSHD and HSHD groups. Furthermore BMI of the HSLD group was higher than the other groups(p<.05). In conclusion, high static/low dynamic group were greater in %fat, LBM, BMI than other groups. The differences observed between different sports groups and classification of sports are related to metabolic and dynamic properties in different sports events.

차아염소산나트륨과 클로르헥시딘의 반응침전물 형성방지를 위한 여러 가지 근관세척 방법의 비교

최문선,박세희,조경모,김진우 大韓齒科保存學會 2010 Restorative Dentistry & Endodontics Vol.35 No.2

The purpose of this study was to compare the different canal irrigation methods to prevent the formation of precipitate between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Extracted 50 human single-rooted teeth were used. The root canals were instrumented using NiTi rotary file (Profile .04/#40) with 2.5% NaOCl and 17% EDTA as irrigants. Teeth were randomly divided into four experimental groups and one control group as follows; Control group: 2.5% NaOCl only, Group 1: 2.5% NaOCl + 2% CHX, Group 2: 2.5% NaOCl + paper points + 2% CHX, Group 3: 2.5% NaOCl + preparation with one large sized-file + 2% CHX, Group 4: 2.5% NaOCl +95% alcohol+ 2% CHX. The teeth were split in bucco-lingual aspect and the specimens were observed using Field Emission Scanning Electron Microscope. The percentages of remaining debris and patent dentinal tubules were determined. Statistical analysis was performed with one-way analysis of variance (ANOVA). Energy Dispersive x-ray Spectroscopy was used for analyzing the occluded materials in dentinal tubule for elementary analysis. There were no significant differences in percentage of remaining debris and patent tubules between all experimental groups at all levels (p > .05). In elementary analysis, the most occluded materials in dentinal tubule were dentin debris. NaOCl/CHX precipitate was detected in one tooth specimen of Group 1. In conclusion, there were no significant precipitate on root canal, but suspected material was detected on Group 1. The irrigation system used in this study could be prevent the precipitate formation. 이 실험의 목적은 NaOCl과 CHX의 혼합사용 시, 발생하는 침전물의 형성을 막기 위해 두 용액간의 접촉을 줄일 수 있는 여러 가지 방법을 비교하고, 관찰된 침전물의 원소를 분석하는 것이다. 발거된 50개의 단근치를 사용하였으며 2.5% NaOCl을 이용하여 .04 taper ProFile #40까지 근관형성 하였다. 치아는 다음과 같은 근관세척 방법에 따라 4개의 실험군과 1개의 대조군으로 나누었다; 대조군: 2.5% NaOCl, 1군: 2.5% NaOCl + 2% CHX, 2군: 2.5% NaOCl + paper points + 2% CHX, 3군: 2.5% NaOCl + .04/#45 근관확대 + 2% CHX, 4군: 2.5% NaOCl +95% alcohol+ 2% CHX. 근관세척 후 치아를 양분하고 치관부, 중간부, 치근부 세부위로 나누어 전계 방사형 주사 전자현미경을 통하여 잔사 비율, 개방 상아세관 비율, 상아세관 내 물질의 원소분석을 시행하였다. 실험결과, 실험군 사이에 잔사비율과 개방된 상아세관 비율 비교에서 통계학적으로 유의할 만한 차이는 나타나지 않았다. 1 군의 한 시편에서 C의 함유량이 높게 나타났으며 N과 Cl도 함께 검출되어 para-chloraniline으로 추정되며, 1 군의 다른 시편과 나머지 실험군에서는 O, P, C, Ca의 순으로 함유량이 높은 것으로 나타나 수산화인회석으로 추정된다. NaOCl 세척 후 바로 CHX 세척을 한 군에서 PCA로 의심되는 물질이 검출된 바, 두 용액의 직접적인 접촉을 피하기 위해 주의가 필요하며, 본 실험에 사용된 여러 근관 세척방법 이용 시 침전물의 형성을 예방할 수 있을 것이다.

동양 전통과학의 탐구방법론 연구 : 朱子의 格物致知論을 중심으로

최영제,이우붕,정원우,김용수,문장수,방경곤,김기정 경북대학교사범대학과학교육연구소 2005 科學敎育硏究誌 Vol.29 No.-

mecA 양성 메티실린 내성 포도구균의 mec 조절유전자에 대한 분자역학적 연구 및 다양성 분석

우희연,이남용,맹성호,한승훈,인경수,김상욱,성승용,김익상,최명식 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.3

목적 : 병원 감염과 지역 감염의 원인균으로서의 중요성이 증가되고 있는 MRSA와 MRCNS의 메티실린 내성 관련 유전자에 대해 분자역학적인 조사를 시행하고 mec 조절유전자의 다양성을 분석하여 분자유전학적 연구와 감염 관리에 기본적 자료를 제공하고자 연구를 시행하였다. 방법 : 본 연구에서는 국내 동일 대학병원에서 분리된 mecA 양성 MRSA 78균주와 MRCNS 36균주를 대상으로 항균제 감수성 검사와 중합효소연쇄반응을 시행하여 표현형과 유전형의 분포를 알아보고 내성 정도와 유전형의 상관성을 분석하였다. 결론 : 최소억제농도를 측정하여 oxacillin 감수성 양상을 알아본 결과 총 90개의 MRSA 임상검체 중 3균주에서 감수성을 보였고, MRCNS 36균주는 모두 내성을 보였으며, 고도 내성을 보이는 균주일수록 다제내성을 보이고 있었다. 중합효소연쇄반응으로 mecA 유전자 유무를 분석하여 mecA 양성을 보인 MRSA 78균주와 MSCNS 36균주 만을 대상으로 mec 조절유전자에 대한 중합효소연쇄반응을 시행하여 유전형의 분포를 조사하였다. 그 결과 MRSA와 MRCNS 모두에서 mecA-Pr-mecA-mecR1-mecI형, mecA-Pr-mecA-mecR1형과 mecA-Pr-mecA-mecR-1의 5′말단형의 3가지 유전형이 공통적으로 관찰되었는데, 이외에 MRSA에서는 mecA-mecR1형, mecA-mecR1의 5′말단형이, MRCNS에서는 mecA-Pr-mecA형과 mecA형이 추가로 분리되었다. 유전형의 분포를 연도별로 분석한 결과 연도별로 우세한 유전형이 서로 다른 것을 알 수 있었다. 유전형과 내성 정도의 상관성을 분석한 결과, mecA-Pr-mecA-mecR1을 보유한 MRSA의 경우 mecA 억제유전자로 생각되는 mecI 유전자 유무에 관계없이 모두 고도 내성을 나타내어 mecI의 유무는 내성 정도와는 일정한 관련이 없었으나, MRSA와 MRCNS 모두에서 mecI와 동시에 mecR1의 3′말단이 결혼된 유전형이 저도 및 중등도 내성을 보이는 균주에서 유의하게 많이 관찰되어 mecI가 결손된 균주에서는 mecR1의 3′말단부위의 유무가 내성 정도의 결정에 중요한 역할을 할 것으로 생각하였다. 결론 : 국내에서 분리되는 메티실린 내성 포도구균의 유전형의 분포가 국외 분리주와 차이를 보이는 것으로 관찰되었다. 또한 기존의 보고와는 달리 메티실린 내성 정도와 유전형 사이에 유의한 연관성이 있는 것으로 관찰되어 mec조절유전자가 내성 발현 뿐만 아니라 내성 정도의 결정에 중요한 역할을 하는 것으로 관찰되었다. MRSA가 중요한 감염균임에도 불구하고 아직까지 MRSA의 내성기전에 대해 확실하게 규명되지 않아 치료가 더욱 어려워지고 있는 실정이므로 이에 대한 더욱 종합적인 연구와 동시에 발생과 확산을 막기 위한 노력이 필요할 것으로 생각된다. Background : High prevalence of methicillin resistance has been noticed in staphylococci which also have been recognized as important nosocomial and multi-drug resistant pathogens. In this study, we investigated the distribution of mec regulator genes and the presence of the mutation in mecIgene to reveal the resistance mechanism at molecular level. Methods : The isolates included 90 clinical isolates of MRSA, 36 MRCNS of which methicillin resistance were determined by disk diffusion test and isolated in a single hospital during 1996-1999. We performed microdilution MIC test for oxacillin resistance and Kirby-Bauer test for other antibiotics. Genotypes of mecA positive (determined by PCR) isolates (78 MRSA, 36 MRCNS) were investigated by PCR amplification of mec regulator genes such as 3' end and 5' end of mecR1. mecI, and Pr-mecA. Results : In MIC assay, all MRSA strains except 3 strains and all MRCNS strains showed oxacillin resistance. The level of resistance correlated to the multi-drug resistance. Seven genotypes were observed in mecA positive MRSA and MRCNS. Differences of predominant genotypes among years isolated and among species were observed. Deletions of the 3' end of mecR1 and the mecI were more frequently observed in the low- and borderline-level resistant MRSA and MRCNS (P(0.05). So the important role of 3' end of mecRI in determining resistance level was suggested. Conclusion : This study demonstrated that genomic distribution of methicillin-resistant staphylococci isolated in Korea was different from that of strains isolated in other countries. And important role of mec regulator genes for expression of methicillin resistance was suggested.